Individual
DENNA R. WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1919 STATE ST STE 364, NEW ALBANY, IN 47150-6801
(812) 949-5767
(812) 948-4339
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4917
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000218A
IN
363AM0700X
Medical Physician Assistant
PA639
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005223
—
IN
05
—
95001467
—
KY
01
—
IN1189190
IN MEDICARE
IN
Enumeration date
06/08/2006
Last updated
12/10/2020
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